The Immunological Effects of Hypertonic Saline

Abstract

Sporadic reports on the use of high salt crystalloid solutions, or hypertonic saline, date back to the beginning of the 20th century. Hypertonic solutions were most often used to correct electrolyte abnormalities, but also to induce peripheral vasodilatation and to transiently increase blood pressure [1]. De Felippe et al. [2] reported the first clinical study with hypertonic saline solution in 1980. This Brazilian study reported that small volumes of hypertonic saline administered to 12 trauma patients in extremis of hemorrhagic shock resulted in a remarkable increase in blood pressure, with nine patients leaving the hospital alive. Curiously, during the following 10 years, a large number of studies and considerable effort focused on trying to understand how hypertonic saline increased blood pressure instead of focusing on why nine out of 12 patients who should have died, survived.